Medical Records, St. Joseph Hospital, Orange
To receive copies of your medical records, a dated and signed authorization is required by the patient or legal representative. Authorizations signed by a representative must include a copy of the Durable Power of Attorney, guardianship, etc.
Medical records authorization forms
The authorization must include the following information to be valid:
- Patient's Full Name (including any former name)
- Patient's Date of Birth
- Name and address of the patient or authorized representative to release
- Name and address of the person/entity receiving the information
- Date(s) of treatment or service needed
- Specific information to be released (i.e. lab report)
- Purpose for which the information may be disclosed (continuing medical care, insurance, personal use, and legal)
- Expiration date when the authorization is no longer valid
- Dated and signed by the patient or an authorized representative
There is a fee to receive personal copies of a patient's medical record. The request should be emailed, mailed, faxed or brought to the Medical Records Department, located on the lower level of St. Joseph Hospital.
If you have any questions regarding the fee, please contact our Medical Records Department and speak to a Release of Information Representative:
Hours; Mon. - Fri: 8 a.m. to 4:30 p.m.
To obtain copies of medical records please mail, fax or email your signed completed authorization to:
St. Joseph Hospital
Medical Records Department
1100 W. Stewart Dr., Orange, CA 92868
Attn: Medical Records
Release of Information